GENERAL REPORT OF THE COGNITIVE TESTING MÉXICO INSTITUTO NACIONAL DE ESTADISTICA, GEOGRAFÍA E INFORMÁTICA (INEGI) Sixth meeting of the Washington Group in Disability Statistics October 10-13, 2006 Kampala, Uganda

INEGI decided to do the Cognitive testing proposed by WCG, with its own resources. It was carried out from the 6th to the 10th of June. In each household, there was at least one person with a disability. 82 households interviewed. 326 people interviewed. Two central states (Aguascalientes and Mexico City). BACKGROUND

INTERVIEWERS Educational level of the interviewers: 7 have concluded professional's level 3 have high school studies All of them are Spanish-speakers

A Manual was elaborated for the interviewer, it can be used as a guide for training and as auxiliary manual through the interviews, and the content was: It was qualified in two days, in the first, the instrument and the precisions of the sections were seen, and in the second day doubts and problems were solved. A pilot exercise was carried out, it consisted in applying the instrument in a complete households, the procedures were revised again and the necessary adjustments were made. to specify the test’s objectives as the questions Instructions of filling out, recommendations to carry out the interview depending on type of the person's limitation; recommendations to solve difficult cases and operative aspects. TRAINING

Observation unit: households with at least one person with disability. The private and public institutions, which work with and for the people with disability gave us the information abut the households. Total of people interviewed: 326 people in 82 households. Average number of interviews by household: 4 people. Average time for interviews by household: 2:45 hrs. RESPONDENTS

Distribution of the households by type of disability

The respondents' profile social – demographic All the selected households had knowledge of the test An appointment was settled for the interview, The dates and hour were selected by Interviewed people taking into account that in the households there were present most of people.

In the cases where when one of them couldn’t be present (by personal reasons) in the interview, Another case, was when the person (respondent) suffered from a severe disability, that did not allow him to answer the interview by himself, (the information was provided by his parents or the person who is in charge of his care) A third case was when the “informant” was a small child (babies and children under 6 years of age). The interviews were classified in the two following ways: SELF REPORT: when the interview was made directly with the respondent; in other words, the informant answered all questions PROXY REPORT: When the person’s information was provided by a third person under his authorization: REPORT TYPE

Sex and Age 46.9% was applied to men and 53.1% to women. 16.9% of the interviews were made to children among 0 to 14 years old. 14.7% to people of 60 and more years. 23.6% to young population between 15 and 29 years and 44.5% to the population of 30 to 59 years old.

The questionnaire mainly has maintained its original structure from its English version; but it was necessary to make some adjustments to the sections to assure their application and monitoring. First change: A section was elaborated for the household where we included the list of people in the household, some data demographic requested for the household in the cognitive testing and another information like control measurement. Geographical location Place of the interview Control of the household and questionnaire Lists of people in household Duration of the interview Name of the interviewer Household income (monthly) The obligation clauses and confidentiality Observation’s section. QUESTIONNAIRE

Second change: In some of the questions, about data of the informant, slight modifications were made to adapt the questions our native language. In addition proven questions in the Count of Population and Housing 2005 were used. The modified questions were the following ones: Educational level Original WCG structures: 2. How many years in all did you spend studying in school, college or university? Years _____ Adaptation for Mexico:

Household income Original WCG structures: 5. What is your household income? (See card) (J, C, M, F, S, K, P, D, H, U, N) Adaptation for Mexico: The total amount of household income (monthly) was asked in national currency and finally the conversion was made to Euros and it was classified according to the table that proposed by WCG.

Construction of application universes (domains) For every domain of the test, different subgroups were constructed, depending on if they use or no helps or equipments; in these cases a careful review was done and we evaluated the possibility of dividing them in sections. This was done in all the sections that required it.

Third change: Following some recommendations of the WCG, at the end of the questionnaire a section on disability was added, with questions on type and cause of disability that were used in the XII General Census on Population and Housing 2000, a question on age at disability onset was added too.

The translation work was performed by personnel from INEGI that have an appropriate knowledge of the English language and some knowledge on the subject; the translating process was the following: Two independent translations were prepared of the questionnaire that the WCG sent us. From those two translations, a third version was prepared that suffered modifications when it was compared with the concepts used by ICF, some tests were made to evaluate their understanding. When the time arrived to design the questionnaire and from the observations received by the expert personnel in the instrument design, some doubts arose. We returned to the original questionnaire and ICF, and a fourth version of the translation was obtained, which was used for the rising. Problems and difficulty in the process of the translations The meaning of some words of the questionnaire in English didn't correspond to used in Spanish language, as technical terms, regionalisms and doubts of the operative TRANSLATION OF THE QUESTIONNAIRE

HEARING The cuestion: Do you wear a hearing aid all of the time,, only for certain activities, or none of the time? In this cuestion are included the answer options, it was made extensive an repetitive; to avoid this situacion, the first part of the question was equal: Do you wear a hearing…? And the rest of cuestion were left in the answer option The sentence: In to croweded room? “Room” refered to type of physical espace, so that the informat kept in mind that it could be in any space, not alone a “room” this word change by “PLACE”. The same happened in the sentence “quiet room” TRANSLATION OF THE QUESTIONNAIRE

HEARING The cuestion: How often do you MISS words in conversation or on the radio or television because you have difficulty hearing? The respondent’s interpretation was afirmative, How often do you LISTEN WELL words in conversation or on the radio or television because you have difficulty hearing? For the cuestionnaries in Spanish io change the writing in affirmative form for to reduce the mistake. QUALITATIVE ANALYSIS

RESULTS

Distribution of people by domain

Vision

Hearing

Cognitive

Lower Mobility

Self-care

Communication

1. The core question on Cognitive (concentration and memory) it turns out to be very general; additionally, for the case of Mexico it is not a term that is known for all. The words we opt. were: "To REMEMBER AND CONCENTRATES", but they were of little common use and therefore, the informants don't put them in the context of a daily situation. 2. In Communication the question is too long and confuse for some informants (both versions, Spanish and English) although it was included in the context of the same one. CONCLUSIONS

On the operative aspects: 3. Some type of filter is required in order to apply the questions according to the age of the respondents or to carry out the necessary modifications to define those core questions that can present biases for the age of the respondents.

Thank you for your attention